Organization
IRVINGTON PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNIER LAUREDAN MD (MEDICAL DIRECTOR)
(973) 371-1600
Entity
Organization
Contact information
Practice address
22 BALL ST, SUITE 100, IRVINGTON, NJ 07111-3521
(973) 371-1600
Mailing address
22 BALL ST, SUITE 100, IRVINGTON, NJ 07111-3521
(973) 371-1600
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
25MA05388700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0677701
—
NJ
Enumeration date
07/11/2006
Last updated
08/22/2020
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